Osteoarthritis 715

synonyms: OA, osteoarthritis, DJD, degenerative joint disease

Osteoarthritis ICD-9

Osteoarthritis Etiology / Epidemiology / Natural History

• Age related damage to articular cartilage and associated bony remodeling.
• Risk Factors: age, female sex, prior joint injury, family history, obesity.
• Prostaglandin E₂ has been demonstrated in OA cartilage demonstrating that inflammation is envolved in OA.

Osteoarthritis Anatomy

• Most commonly affects: hands, feet, knees, hips, spine.

Osteoarthritis Clinical Evaluation

• Activity related joint pain;
• Joint stiffness related to inactivity.

Osteoarthritis Xray / Diagnositc Tests

• Four primary Xrays findings of osteoarthritis:
  1-loss of joint space
  2-subchondral sclerosis
  3-osteophyte formation
  4-subchondral cysts

Osteoarthritis Classification / Treatment

• Activity modification
• Exercise: low-impact excercise including isokinetic and isotonic strengthening improves symptoms, function and cartilge glycosaminoglycan content. (Roddy E, Rheumatology 2005;44:67). AOSSM TEAM exercises
• AOSSM Osteoarthritis and Exercise
• Cane/walker (Blount WP, JBJS 1956;38A:695).
• Acetaminophen / NSAIDs
• Glucosamine sulfate / Chondroitin Sulfate:Glucosamine 1500mg daily, Chondroitin 800md daily.
• ASU (Avocado/Soybean) generally used as an addition to glucosamine/chondroitin: ASU 300mg daily.
• Green Tea extract
• Corticosteriod injections
• Viscosupplementation (Hyaluronic acid injections): Can provide up to 6 months of improvement. (Arrich J CMAJ 2005;172:1039). Side effects: injection site pain, pseudoseptic reaction, infection.
• Weight loss: reduces risk of OA progression and improves symptoms and function (Messier SP, Arthritis Rheum 2004;50:1501).
• Surgical Options: THA, TSA, TEA, TKA, etc

Osteoarthritis Associated Injuries / Differential Diagnosis

• Osteoarthritis
• Fibromyalgia
• Psoriatic Arthritis
• Ankylosing Spondylitis
• Rheumatoid Arthritis

Osteoarthritis Complications

Osteoarthritis Follow-up Care

Osteoarthritis Review References